Service coproductions as reciprocal activities

In addition to extrinsic economic exchange, #JohnMCarroll #JiaweiChen #ChienWenTinaYuan #BenjaminHanrahan @ISTatPENNSTATE say service coproductions relying on all participants to collaborate in both economic exchange and social exchange.

Service coproduction is a special case of service provision in which the roles of service provider and service recipient both require active participation. Examples include healthcare, education, and music instruction. Service coproduction raises particular challenges for user interface design. Because the recipient plays an active role, interaction protocols cannot be fully specified at design time and it is difficult to clearly define what the provider is providing and what value to attach to the provider’s contribution.

A coproduced service is a reciprocal collaboration, and it is both an economic exchange and a social exchange. [1] [Carroll, Chen, Yuan, Hanrahan 2016, p. 27, editorial paragraphing added] [….]

  • [1] J.M. Carroll and V. Bellotti, “Creating Value Together: The Emerging Design Space of Peer-to-Peer Currency and Exchange,” Proc. 18th ACM Conf. Computer Supported Cooperative Work & Social Computing (CSCW 15), 2015, pp. 1500–1510.

A more radical example of service coproduction is timebanking, in which personal services are exchanged and valued according to the time to produce them. [2] In timebanking, no money is exchanged; services are valued by the doing itself. Moreover, because these exchanges occur in a local (face-to-face) community context, an exchange’s value includes personal recognition of a neighbor’s effort and reciprocal recognition of the value inherent in helping a neighbor. Timebanking service exchanges are, by design, not simple and succinct pay-and-receive services, like music streaming. Indeed, participants can spend earned time credit only on arranging further cooperation with neighbors. [1] [Carroll, Chen, Yuan, Hanrahan 2016, p. 27] [….]

Services are often construed as an exchange between a provider and a recipient in the form of material or money. The provider delivers a service to the recipient; for example, a taxi driver transports passengers, or a media company streams content to a subscriber. In return, the recipient pays the service provider. [….] However, some services are not as straightforward as that. For example, an educator cannot “deliver” knowledge and skill to a student; if the student does not react (through, say, practice and reflection), learning does not happen. Many services or activities pertaining to health and learning are, in this sense, coproduced social exchanges. The provider and recipient actively cooperate to produce social values that both parties share. [Carroll, Chen, Yuan, Hanrahan 2016, p. 27] [….]

In other words, the shared, interdependent aspect of the production process is key in successful coproduction activities. This means that service coproductions can be improved and customized by leveraging the expertise of both providers and recipients, enabling increased diversity and choices. Recipients can be more responsive to the services provided, and costs can decrease. [5] [Carroll, Chen, Yuan, Hanrahan 2016, p. 28]

  • [5] T. Brandsen and V. Pestoff, “Coproduction, the Third Sector and the Delivery of Public Services: An Introduction,” Public Management Rev., vol. 8, no. 4, 2006, pp. 493–501.

The article makes the ideas concrete with a research smartphone app WithShare (on iOS).

FIGURE 1. Screenshots of our timebanking smartphone app (names anonymized).
(a) The task list view (offer). (b) The add-task view (request). (c) The task details view (offer).
(d) The user profile view. Users can set up service exchanges; in Figures 1b and 1c, a
mother home alone with a sick child is requesting someone to obtain medicine for her.


Carroll, J. M., J. Chen, C. W. Yuan, and B. V. Hanrahan. 2016. “In Search of Coproduction: Smart Services as Reciprocal Activities.” IEEE Computer, July 2016, pp. 26-32. , cached at

#service-science, #service-systems

2013/10/10 15:00 “Design for Care: Human-Centering in Healthcare Service Systems” | Peter Jones | Relating Systems Thinking & Design 2013

Digest from #RSD2 by Peter Jones @designforcare at Relating Systems Thinking and Design 2 at AHO Oslo School of Design and Architecture

This digest was created in real-time during the meeting, based on the speaker’s presentation(s) and comments from the audience. The content should not be viewed as an official transcript of the meeting, but only as an interpretation by a single individual. Lapses, grammatical errors, and typing mistakes may not have been corrected. Questions about content should be directed to the originator. The digest has been made available for purposes of scholarship by David Ing.

European launch of Design for Care, publication is at

Presentation is available at


Introduction by Birger Sevaldson

[Peter Jones]

Trying to start a new program on healthcare design at OCAD

Current program on Strategic Foresight and Innovation, looking 50 years out

  • More policy work and large scale design

Rosenfeld Media started 5 to 6 years ago with craft-oriented book

  • Now on second generation design of book
  • Worked with James Caldwell on this book look

Two books before:

  • Team Design (now rarely used)
  • We Tried to Warn You:  a single case study

Healthcare is different to talk about credibly, not a clinician

  • Had worked in point-of-care informatics
  • When deep in healthcare, it’s impossible to get context around the field
  • Depth becomes breadth

Book has 9 chapters, different cases, methods appropriate across different sectors

  • Person at home, in everyday life
  • Clinical context, providing care services
  • Organization / institutions in health policy

Stories about how people experience fragmentation

Main question:  What if designers were included in the team, as care professionals?

  • Designers working in healthcare aren’t included uniquely, unless they’re in niche
  • Wicked problem

Designers are not helping systemically

  • Fields of design are fragmented
  • User experience / interaction design
  • Service design
  • Evidence-based design
  • Environmental design
  • Participatory design
  • Generative design
  • Disruptive innovation

Rethinking sociotechnical systems

  • Complex service systems, but they don’t benefit from the knowledge of service systems

In North America, no accepted design process

  • Institutions are reinventing design language
  • Sociotechnical systems, absent service design

DFC003: Figure 1.2

Adapted from Humantific, 2007-2003:  design geography, scales of design

  • Design 1.0:  Traditional design
  • 2.0:  Product / service design
  • 3.0:  Organizational transformation design
  • 4.0:  Social transformation design
  • Healthcare involves all 4 levels
  • Complexity increases at each level
  • Design skills do not transfer up (and may not even transfer down, that well)

In healthcare, at various scales:

  • Design 1.0 and 2.0:  Differencing, as opposed to making sense
  • Branding, clarity in communications
  • e.g. wayfinding can be done by a single experienced designer, not a team of designers
  • About making things stand out

Design 3.0 might have straightforward service design, e.g. providing vaccination

  • Could be designing IT services

Design 4.0:  Healthcare may not be at level of transformation

  • In Canada, at current rate, healthcare will be 100% of tax dollars in 15 years
  • Integrating services to architecture, can’t touch on in book
  • Accountable Care Organization (coming with Obamacare) is a new business model being pushed down into organization

Financial incentives to push costs down

  • But following yesterday’s processes
  • Aren’t likely to change unless institutionalized
  • Opportunity for designers at policy level to make changes
  • A high-authority environment

Let’s get designers started in healthcare

Contexts of care services

  • Human
  • Work and activities
  • Organization
  • Industry

3 human-centered contexts

1. Persons, not users, or patients

  • People as health seekers, service customers
  • Evidence-based care, as scientific approach, almost ignores the perspective of nurses who take a strong care approach

2. Clinical work practices

  • Healthcare business must also be designed

3. Healthcare system

  • Design

Character: Elena

  • Single mother taking care of farther and daughter
  • Care giver’s journey


1. Health seekers

  • As human beings, we are homeostatic
  • Whether we aim for optimal health, or just normal health (where normals are measured differently)
  • Think of selves more as agents than as patients (unless we’re in bed)

Elena’s journey as situations:

  • Caregiving
  • Health incident
  • Diagnosis
  • Treatment
  • Living With

Coulter, Entwistle Gilbert (1999) Sharing decisions with patients, British Medical Journal: Information touchpoints

  • 1. Understanding what is wrong
  • ….
  • 12.

DFC042: Figure 6.1

An end point:  Patients Like Me, started by a man whose brother died from ALS

  • Became a self-managed disease site
  • People track daily
  • Open and free
  • They are e-patients, agents in changing the way patients are treated

2.  Designing for clinical services, around clinical informatics to answer questions at point of care

  • Doctors don’t want to read journal articles, or 14-page summary
  • They want 3 to 4 pages
  • Workflow today, IT wants to take templates that know have worked in past, and then adapt workflows

Richard Bohmer:  Designing Care: Aligning the nature and management of health care, HBR press, talks about care contexts

  • Sequential services
  • Iterative services: a mix of conditions
  • Now 30% of patients are showing signs of diabetes or obesity in a mix of conditions
  • Care should be iterative
  • Uncertainty should be reduced during care, it’s like research through design
  • Improvements to treatment have to be done by trying them
  • More a problem-solving approach

Elena, seeing multiple specialists (for her fainting spell)

  • Elena is flooded by information

In clinical context, gold rush in Electronic Health Records systems number in hundreds, although only 5 are in use in the U.S. due to reimbursement systems

(Diagrams from book are available in Flickr)

Project Synapse, by IDEO and California HealthcCare Foundation 2012 (by Kauffman Foundation)

3.  Healthcare Systems

  • Call Big Box Healthcare
  • Michael Porter:  value-based healthcare system, driven by policy, not innovation
  • Cost will be the big disruptor

Center for Innovation in Complex Care in Ontario, Morra 2012 Reconnecting the pieces to optimize care in Atrial Fibrillation in Ontario

  • Patient-centred system

Value-Based Care, Porter and Lee in October HBR with Cleveland Clinic

  • Integrated practice units, distributed across organizations
  • Cost and outcome measurement

Designing Services to Scenario

To Design for Care is to Design for Health


Evidence-based medicine?

  • TR Reid, bad shoulder, reported across multiple systems
  • Can improve a lot of things in healthcare they won’t impact costs
  • Could be Health 3.0 or 4.0, may require policy changes

Design for care

Peter jones

[Table of contents for book at]

Table of Contents

Part One: Rethinking Care and Its Consumers

  • Chapter 1: Design as Caregiving
  • Chapter 2: Co-creating Care
  • Chapter 3: Seeking Health

Part Two: Rethinking Patients

  • Chapter 4: Design for Patient Agency
  • Chapter 5: Patient-Centered Service Design

Part Three: Rethinking Care Systems

  • Chapter 6: Design at the Point of Care
  • Chapter 7: Designing Healthy Information Technology
  • Chapter 8: Systemic Design for Healthcare Innovation
  • Chapter 9: Designing Healthcare Futures

#design-for-care, #healthcare, #rsd2, #service-systems